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Acne Surgery

Acne surgery may be used by to remove blackheads and whiteheads. Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation, pigmentation and scarring may result.


After years of sun, squinting, laughing, frowning, smoking, and worrying, the skin around the eyes and on the forehead will often develop deep lines and wrinkles called “expression lines.” A frequent concern is that they often make you look older, tired, or stressed. Until recently, these advanced furrows have been difficult to treat. Now, by utilizing this FDA approved muscle-relaxing agent, expression lines can be significantly reduced.


Canthrone is an excellent treatment for warts, molluscum and other growths in the skin. It is painless and therefore preferred by many of our pediatric patients and adults who are adverse to even a little discomfort.

Chemical Peels

Men and women alike share a common desire to have healthy, youthful skin. Exposure to the sun and the elements in combination with adverse living habits contribute to the appearance of our skin. Chemical Peels are increasingly popular with those who are unhappy about acne scarring, sun-damaged skin, age spots, freckles, fine lines, rough skin and uneven pigmentation. A chemical peel is not limited to just the face, and can be performed on the neck, chest, hands, arms, shoulders and leg now with little or no downtime!

Ear Pierced with 24 Karat Studs and Sterile Technique

The Coren PS earpiercer painlessly pierces your earlobes and inserts a hypoallergenic ear stud.

Earlobe Repair

Torn earlobe repair is an easy in office procedure that takes approximately 30 minutes from start to finish. Under local anesthesia an enlarged earring hole is closed or a torn earlobe is restored. The sutures are removed in just one week. Dr. Robinson can re-pierce your ears 6 weeks later (see Pierced Ears). So go ahead and get those earrings you always wanted but couldn't wear.


Electrodessication can eliminate small growths without your friends knowing you had anything done. The rapid healing time and excellent cosmetic results make this a favorite treatment for our patients.

Erbium Laser

Erbium laser treatments are ideal for the improvement of wrinkles, acne scars, sun damage and brown spots. While this treatment provides a more youthful appearance it usually requires a week of down time.

Fraxel® DUAL Laser

 The Fraxel® DUAL Laser system has the unique advantage of two treatment modes/wave lengths in one Laser.  This non-surgical procedure smooths wrinkles and scars, improves texture , tone, elasticity, color and also minimizes pore size.  The Fraxel® DUAL Laser uses patented fractional technology to target sun damaged skin.  The laser treats only a fraction of tissue at a time, leaving the surrounding tissue untouched, which promotes rapid healing. This stimulates your body's own natural healing process, replacing the old and damaged cells with fresh, glowing, healthy skin.  The result is more youthful, radiant skin with minimal down time.  Any area of the body can be treated:  face, chest, neck and hands.

Hoya ConBio Medlite Q-switched Nd:Yag Laser

The Medlite laser is the best choice for brown spot and tattoo removal. It has been compared to taking a pencil eraser and removing years from the appearance of your skin. The Medlite Laser effectively removes brown age spots, "liver spots", freckles and other brown birthmarks, such as cafe-au-lait spots and Nevus of Ota.


Incision and Drainage

This procedure involves the opening and draining of acne cysts, epidermoid cysts and abcesses to speed healing and help prevent scarring.

Intralesional Injections

Intralesional injections are ideal for quick healing and relief from pain caused by an acne pimple(s), cyst or scar. Prompt treatment with intralesional injections can often prevent scarring. Please don’t pick as this can promote scars, light and/or dark spots.


JUVEDERM injectable gel is a smooth gel filler Dr. Robinson eases under your skin to instantly smooth out those wrinkles or folds that look like parentheses along the side of your nose and mouth. Results are immediate, smooth and natural. Everyone will notice but no one will know.

Laser Hair Removal

Dr. Robinson offers GentleLase and GentleYag hair removal options. The GentleLase Laser is the gold standard for hair removal in caucasions. The GentleYag laser is the gold standard for laser hair removal in patients of color or tanned skin and is also an excellent treatment for facial, leg, spider veins and hemangiomas. These treaments also provide excellent results in the removal of brown spots such as sun spots (liver spots) and flat benign brown keratoses. Candela's (the makers of the GentleLase) patented Dynamic Cooling Device (DCD) technology protects the upper layers of your skin with a cooling mist. Together, the long-pulse laser and DCD cooling offer optimal treatment with minimal side effects.

Laser Skin Resurfacing

This treatment is excellent for acne scarring as well as sun damaged or aged wrinkled skin. The laser vaporizes the damaged skin and commences the regeneration of fresh skin during the following weeks. The thermal heating of the deep tissue stimulates new skin growth, promoting a healthy new collagen layer. This is usually accompanied by a week of healing time.

Laser Skin Tightening

The GentleYAG Laser uses a light beam that penetrates deeply into the skin resulting in tighter, smoother looking skin.


Anyone can get head lice.  It has nothing to do with cleanliness. Head lice only survive on humans and do not affect family pets. Shared hats, helmets, clothing, combs, brushes, headbands, hair ties, headrest, pillows, linens, towels and other personal articles are perfect vehicles to transfer lice from one person to another.


Liquid Nitrogen

Liquid Nitrogen is a cold spray that is used to treat cosmetically unacceptable lesions precancerous growths and warts. The rapid treatment and healing allow for exceptional aesthetic results.


Microdermabrasion is a non-surgical exfoliating treatment helpful for those unhappy with scars, acne scars, sun-damaged skin, pigmentation spots, stretch marks, fine lines, and rough skin. Treatment can be performed anywhere on the body. This treatment works for scarring especially when used in conjunction with other modalities.


RADIESSE is a safe, FDA-approved dermal filler that restores a natural, youthful look and lasts longer than the former leading fillers. This convenient treatment fills and corrects smile lines, nasolabial folds, breaks in the tear troughs and wrinkles around the nose and mouth. RADIESSE is made of unique calcium-based microspheres suspended in a natural gel that is injected into the skin through a simple, safe and minimally invasive procedure. The results are immediate and last 10 to 18 months.


Restylane® products are cosmetic dermal fillers that replace lost volume and restore youthful contours to the skin to smooth away moderate to severe facial wrinkles and folds.


Rosacea is a common skin disease that causes redness, papules, and swelling on the face. Often referred to as "adult acne," rosacea frequently begins as a tendency to flush or blush easily. It may progress to persistent redness in the center of the face that may gradually involve the cheeks, forehead, chin, and nose. The eyes, ears, chest, and back may also be involved. With time, small blood vessels and tiny pimples begin to appear on and around the reddened area; however, unlike acne, there are no blackheads.

When rosacea first develops, the redness may come and go. Some people may flush or blush and never form pustules or papules. Small dilated vessels also may be present. However, when the skin doesn't return to its normal color, and when other symptoms such as pimples and enlarged blood vessels become visible, it's best to seek advice from a dermatologist. The condition may last for years, rarely reverse itself, and can become worse without treatment.

How to Recognize Rosacea

Small red bumps, some of which may contain pus, appear on the face. These may be accompanied by persistent redness and the development of many tiny blood vessels on the surface of the skin.

In more advanced cases, a condition called rhinophyma may develop. The oil glands enlarge causing a bulbous, red nose, and puffy cheeks. Thick bumps may develop on the lower half of the nose and nearby cheeks. Rhinophyma occurs more commonly in men.

Who is at RiSk for Rosacea?

Fair skinned adults between the ages of 30 and 50 may develop rosacea. It affects men and women of any age, and even children. Since it may be associated with menopause, women are affected more often than men and may notice an extreme sensitivity to cosmetics. An occasional embarrassment or a tense moment also may trigger flushing.

Tips for Rosacea Patients

  • Avoid triggers, including hot drinks, spicy foods, caffeine and alcoholic beverages that make the face red or flushed. It's important to note that although alcohol may worsen rosacea, the condition may be just as severe in someone who doesn't drink at all; thus rosacea has been unfairly linked to alcoholism.
  • Practice good sun protection. Seek shade when possible and limit exposure to sunlight, wear hats and use broad spectrum sunscreens with SPF of 15 or higher; reapply every 2 hours.
  • Avoid extreme hot and cold temperatures which may exacerbate the symptoms of rosacea. Exercise in a cool environment. Do not overheat.
  • Avoid rubbing, scrubbing or massaging the face.
  • Avoid cosmetics and facial products that contain alcohol. Use hair sprays properly, avoiding contact with facial skin.
  • Keep a diary of flushing episodes and note associated foods, products, activities, medications or other triggering factors.


Many people with rosacea are unfamiliar with it and do not recognize it in its early stages. Identifying the disease is the first step to controlling it. Self-diagnosis and treatment are not recommended since some over-the-counter skin products may make the problem worse.

Dermatologists often recommend a combination of treatments tailored to the individual patient. These treatments can stop the progress of rosacea and sometimes reverse it.

Creams, lotions, foams, washes, gels, and pads that contain various topical antibiotics, metronidazole, sulfcetimide, benzoyl peroxide, and retinoids may be prescribed. A slight improvement can be seen in the first three to four weeks of use. Greater improvement is usually noticed in two months.

Oral antibiotics tend to produce faster results than topical medications. Cortisone creams may reduce the redness of rosacea; however, they should not be used for longer than two weeks since they can cause thinning of the skin and flare-ups upon discontinuation. It is best to use these creams only under the direction of a dermatologist.

The persistent redness may be treated with laser surgery.  This melts the dilated (broken) capillaries that cause most of the redness. Cosmetics may be helpful. Green tinted makeup may mask the redness.

Special Treatments

Rhinophyma is usually treated with surgery. The excess tissue can be carefully removed with a scalpel, laser or through electrosurgery. 

The key to successful management of rosacea is early diagnosis and treatment. It is important to follow all of Dr. Robinson's instructions. Rosacea can be treated and controlled if medical advice is sought in the early stages. When left untreated, rosacea will get worse and may be more difficult to treat.


Heredity is the primary causes of unsightly and often painful varicose and spider veins. Other contributing factors include pregnancy, birth control pills, obesity and standing for long periods of time. As we age, more visible leg veins frequently emerge and our existing veins become increasingly noticeable. There is a simple solution to this problem. A sclerosing solution and a cosmetic procedure called Sclerotherapy!

Skin Rejuvenation

These are treatments that combine procedures to achieve the maximum cosmetic correction and excellence in esthetic appearance. Chemical peels, fillers such as Juvederm or Radiesse and laser treatments including Fraxel work to achieve these results. Dr. Robinson will recommend a treatment course and outstanding cosmetic products to meet your first class expectations.

Snip Removal

Bothered by the moles or skin tags that occur on the neck, face, groin or under the arms or breasts?  Snip removal is an easy way to rid yourself of those annoying growths.  It is often performed without anesthesia or pain. Just a quick snip and it's gone! 


Surgical (Shave and Complete) Excision of Moles

Moles often become more raised over time. Occasionally they become irritated or cut when shaving. A shave excision removes the raised portion of the mole. As a general rule, a complete excision is only performed if a mole is changing or when a complete excision will yield a better cosmetic result. These both are performed under local anesthesia in the our office. The shave excision takes less than a minute and a complete excision under a half hour. The functional and cosmetic results are usually excellent!

Surgical Excision

This option is typically for scars that are deeply pitted, raised, or for older surgical scars that did not heal properly. The scar tissue is removed, followed by careful stitching of the skin to leave a much smaller, thinner scar line or to change the scars shape and/or direction so it is less obvious.

Surgical Excision of Cysts

Cysts may remain asymptomatic but if they continue to grow or become painful surgical excision is the treatment of choice. The cyst consists of a wall that makes the contents. To insure that the cyst does not return it is best to completely excise it, including the wall, to prevent its recurrence.


Ultherapy is the only FDA-cleared non-invasive treatment for lifting the skin on the neck, chin and brow; and now it’s also the only non-invasive treatment specifically FDA-cleared to improve lines and wrinkles on the décolletage! Ultherapy uses focused ultrasound to stimulate collagen deep within the skin, with no downtime required. The result? Tighter, better-fitting skin, from the brow to the chest!

V-Beam Laser - Pulsed Dye Laser

Pulsed Dye Lasers deliver an intense but gentle burst of light into selectively targeted areas of the skin. The light is absorbed by specific blood vessels or pigment depending on the condition being treated. The cosmetic results are magnificent and there are no open wounds or wound care.


VISIA complexion analysis system is an advance photographic system that assesses skin features, provides grading relative to your peer group, uses multi-spectral imaging and delivers your exclusive easy-to-understand customized report including recommendations for treatment and skin care.


Acne is a skin condition which has plugged pores (blackheads and whiteheads), inflamed pimples (pustules), and deeper lumps (nodules). Acne occurs on the face, as well as the neck, chest, back, shoulders, and upper arms. Although most teenagers get some form of acne, adults in their 20's, 30's, 40's, or even older, can develop acne. Often, acne clears up after several years, even without treatment. Acne can be disfiguring and upsetting to the patient. Untreated acne can leave permanent scars; these may be treated by your dermatologist in the future. To avoid acne scarring, treating acne is important.

Types of Acne and How Acne Forms

Acne is not caused by dirt. Testosterone, a hormone which is present in both males and females, increases during adolescence (puberty). It stimulates the sebaceous glands of the skin to enlarge, produce oil, and plug the pores. Whiteheads (closed comedones), blackheads (open comedones), and pimples (pustules) are present in teenage acne.

Early acne occurs before the first period and is called prepubertal acne. When acne is severe and forms deep "pus-filled" lumps, it is called cystic acne. This may be more common in males. Adult acne develops later in life and may be related to hormones, childbirth, menopause, or stopping the pill. Adult women may be treated at the period and at ovulation when acne is especially severe, or throughout the entire cycle. Adult acne is not rosacea, a disease in which blackheads and whiteheads do not occur.


Acne has nothing to do with not washing your face. However, it is best to wash your face with a mild cleanser and warm water daily. Washing too often or too vigorously may actually make your acne worse.


Acne is not caused by foods. However, if certain foods seem to make your acne worse, try to avoid them.


Wear as little cosmetics as possible. Oil-free, water-based moisturizers and make-up should be used. Choose products that are "non-comedogenic" (should not cause whiteheads or blackheads) or "non-acnegenic" (should not cause acne). Remove your cosmetics every night with mild soap or gentle cleanser and water.

A flesh-tinted acne lotion containing acne medications can safely hide blemishes. Loose powder in combination with an oil-free foundation is also good for cover-up.
Shield your face when applying sprays and gels on your hair.


Control of acne is an ongoing process. All acne treatments work by preventing new acne breakouts. Existing blemishes must heal on their own, and therefore, improvement takes time. If your acne has not improved within two to three months, your treatment may need to be changed. The treatment your dermatologist recommends will vary according to the type of acne.

Occasionally, an acne-like rash can be due to another cause such as make-up or lotions, or from oral medication. It is important to help your dermatologist by providing an updated history of what you are using on your skin or taking internally.
Many non-prescription acne lotions and creams help mild cases of acne. However, many will also make your skin dry. Follow instructions carefully.


  • Your dermatologist may prescribe topical creams, gels, or lotions with vitamin A acid-like drugs, benzoyl peroxide, or antibiotics to help unblock the pores and reduce bacteria. These products may cause some drying and peeling. Your dermatologist will advise you about correct usage and how to handle side effects.
  • Before starting any medication, even topical medications, inform your doctor if you are pregnant or nursing, or if you are trying to get pregnant.

Special Treatments

  • Acne surgery may be used by your dermatologist to remove blackheads and whiteheads. Do not pick, scratch, pop, or squeeze pimples yourself. When the pimples are squeezed, more redness, swelling, inflammation, and scarring may result.
  • Microdermabrasion may be used to remove the upper layers of the skin improving irregularities in the surface, contour, and generating new skin.
  • Light chemical peels with salicylic acid or glycolic acid help to unblock the pores, open the blackheads and whiteheads, and stimulate new skin growth.
  • Injections of corticosteroids may be used for treating large red bumps (nodules). This may help them go away quickly.


  • Antibiotics taken by mouth such as tetracycline, doxycycline, minocycline, or erythromycin are often prescribed.

Actinic or Solar Keratosis

These represent pre-cancerous growths that can become skin cancer if left untreated. They are most frequently caused by sun. Besides many topical treatments that can be cumbersome laser and other rejuvenation treatments can affect dramatic improvement and excellent cosmetic results with no social downtime. Dr. Robinson can discuss all the treatment options with you.

Alopecia Areata

lopecia areata (AA) causes hair loss in small, round patches that may go away on their own, or may last for many years. Nearly 2% of the U.S. population (about four million people) will develop AA in their lifetime. Some people with AA (about 5%) may lose all scalp hair (alopecia totalis) or all scalp and body hair (alopecia universalis). The immune system, for unknown reasons, attacks the hair root and causes hair loss.

Who gets AA?

AA occurs world-wide in both genders and in every ethnic group. Children and young adults are most frequently affected, but persons of all ages are susceptible. One in five persons with AA has a family member who also has the disease.

What are the signs and symptoms of AA?

AA usually begins with one or more small, round, coin-size, bare patches. It is most common on the scalp, but can involve any hair-bearing site including eyebrows, eyelashes, and beards. Hair may fall out and regrow with the possibility of full hair regrowth always present. AA usually has no associated symptoms, but there may be minor discomfort or itching prior to developing a new patch. Nails may have tiny pinpoint dents and may rarely become distorted.

What causes AA?

AA is not contagious. It is an autoimmune disease in which the body's immune system attacks itself, in this case, the hair follicles. The cause is not known. A person's particular genetic makeup combined with other factors triggers AA.

What tests are done to confirm AA?

Although your dermatologist may know by examining your scalp that you have AA, occasionally, a scalp biopsy is helpful in confirming the diagnosis.

Is this a symptom of a serious disease?

AA is not a symptom of a serious disease and usually occurs in otherwise healthy individuals. Persons with AA may have a higher risk of atopic eczema, asthma, and nasal allergies, as well as other autoimmune diseases such as thyroid disease (Hashimoto's thyroiditis), and vitiligo. Family members may also have atopic eczema, asthma, nasal allergies, or autoimmune diseases (i.e. insulin-dependent diabetes, rheumatoid arthritis, thyroid disease, or systemic lupus erythematosus).

Will the hair grow back?

Yes, it is likely that the hair may regrow, but it may fall out again. The course of the disease varies from person to person, and no one can predict when the hair might regrow or fall out again. This unpredictability of AA, and the lack of control over it, makes this condition frustrating. Some people lose a few patches of hair, the hair regrows, and the condition never returns. Other people continue to lose and regrow hair for many years. The potential for full regrowth is always there, even in people who lose all the hair on their scalp and body (alopecia totalis/universalis). Hair could regrow white or fine, but the original hair color and texture may return later.

What treatments are available?

There is no cure for AA. While treatments may promote hair growth, new patches of hair loss may continue to appear. The treatments are not a cure. Only the body, itself, can eventually turn off the condition.


are anti-inflammatory drugs that suppress the immune system. They can be given as injections into the areas of hair loss, taken as pills, or rubbed into affected areas. Steroid injections every 3-6 weeks are given directly into hairless patches on the scalp, eyebrow, and beard areas. Hair growth usually begins approximately 4 weeks after the injection. Steroids that are rubbed directly into affected areas are less effective than injections. Corticosteroids taken by mouth have potential side effects. They are not used routinely, but may be used in certain circumstances.

Topical minoxidil 5% solution

may promote hair growth in alopecia areata. Minoxidil 5% solution applied twice daily to the scalp, brow, and beard areas may promote hair growth in both adults and children with AA. New hair growth may appear in about 12 weeks.


is a synthetic tar-like substance that alters immune function in the affected skin. It is applied for 20 to 60 minutes ("short contact therapy") and then washed off to avoid skin irritation. Irritation is not needed in order to stimulate hair regrowth in AA.

Combinations of these treatments may add to the effectiveness. Hopefully, new hair growth will appear in 8 to 12 weeks.

Other Alternatives

Wigs, caps, hats, or scarves are important options. Wearing a head covering does not interfere with hair regrowth. This may be a good choice for people with extensive scalp hair loss who do not have enough hair to cover it.

Will alopecia areata affect life?

The emotional aspects of living with hair loss can be challenging, especially in a society that regards hair as a sign of youth and good health. It is reassuring that alopecia areata does not affect general health, and should not interfere with your ability to achieve all of your life goals at school, in sports, in your career, and in raising a family.

Atypical Nevus (Dysplastic Nevus)

An atypical nevus or dysplastic nevus (mole) is a benign growth that may share some of the features of a melanoma, but is NOT a melanoma or any other form of cancer. The presence of an atypical nevus, however, may increase the risk of developing a melanoma, or be a marker for it. A single atypical nevus may indicate a small risk; this risk increases with the number of atypical nevi present.
What does an atypical nevus look like?

An atypical nevus can vary in appearance. Since it has the ABCDE features of a melanoma, it is important ot have a dermatologist examine all moles.

Asymmetry - One half does not match the other half in size, shape, color, or thickness.

Border irregularity - The edges are ragged, scalloped, or poorly defined.

Color - The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance.

Diameter - While melanomas are usually greater than 6mm in diameter (the size of a pencil eraser) when diagnosed, they can be smaller. If you notice a mole different from others, or one which changes, itches, or bleeds (even if it is small), you sould see a dermatologist.



What are the risks of atypical nevi?

The lifetime risk of a person in the United States developing melanoma is 1 in 75. A patient with one to four atypical nevi without a personal or family history of melanoma is at a slightly higher risk than the general population. The risk of developing melanoma is higher if a patient with atypical nevi has a personal or family history of melanoma. A patient who has multiple atypical and normal nevi (moles) may have Familial Atypical Nevus Syndrome, and is at an increased risk for developing a melanoma, especially if a relative had melanoma.
Where and when do atypical nevi occur?

Atypical nevi begin to appear at puberty and can occur anywhere on the body, but are more common in sun-exposed areas, the back, and the legs.




Since an atypical nevus is not the same as a melanoma, it does not need to be treated aggressively but should be observed for changes, biopsied, or conservatively excised.
Familial Atypical Nevus Syndrome

The National Institute of Health Consensus Conference defines the Familial Atypical Nevus Syndrome as those persons meeting the following criteria:

  • A first-degree (e.g., parent, sibling or child) or second-degree (e.g., grandparent, grandchild, aunt, uncle) relative with malignant melanoma.

  • A large number of nevi, often more than 50, some of which are atypical nevi.

  • Nevi that demonstrate certain microscopic features.

Management of Familial Atypical Nevus Syndroms

It is important for people with Familial Atypical Nevus Syndrome to have a full body screening from a dermatologist every three to twelve months beginning with the onset of puberty. The dermatologist might also recommend regular ophthalmologic examinations, baseline skin photography, or regular screenings of relatives to permit early detection and treatment of melanoma since detection in the early stages has a much higher cure rate.

People with Familial Atypical Nevus Syndrome should also examine their own skin every month. When performing self-examinations, be aware of any lesions that appear to change in size, color, and/or shape. If a change has occurred, bring this to the attention of a dermatologist immediately. Information on the early signs of melanoma is available from the dermatologist or the American Academy of Dermatology.
Prevention of Melanoma

  • Apply a broad-spectrum sunscreen which protects against ultraviolet light (UVA and UVB) and has an SPF of 15 or higher daily.

  • Reapply every 2 hours during prolonged sun exposure.

  • Seek shade whenever possible, especially during peak sun hours between 10 a.m. and 4 p.m.

  • Never use a tanning bed, booth, or artificial tanning devices.

  • Wear a wide-brimmed hat, sunglasses, and other protective clothing like long-sleeved shirts and pants when outdoors.


Basal Cell Carcinoma

Basal cell carcinoma is the most common form of cancer worldwide. In the vast majority of cases, it is thought to be caused by exposure to the harmful ultraviolet rays of the sun. It is becoming more common, perhaps because people may be spending more time outdoors. Some believe that the decrease in the ozone layer is allowing more ultraviolet radiation from the sun to reach the earth's surface. Basal cell cancer does not usually metastasize or travel in the bloodstream; rather it infiltrates the surrounding area destroying tissue. For this reason, basal cell cancer should be treated promptly by your dermatologist with dermatologic surgical techniques.

What does basal cell cancer look like?

basal cell Basal cell cancer most often appears on sun-exposed areas such as the face, scalp, ears, chest, back, and legs. These tumors can have several different forms. The most common appearance of basal cell cancer is that of a small dome-shaped bump that has a pearly white color. Blood vessels may be seen on the surface. Basal cell cancer can also appear as a pimple-like growth that heals, only to come back again and again. A less common form called morpheaform, looks like a smooth white or yellowish waxy scar. A very common sign of basal cell cancer is a sore that bleeds, heals up, only to recur again.

I think I have a basal cell cancer. What should I do next?

If you have a sore that doesn't heal, or that looks like any of the growths pictured in this pamphlet, you should make an appointment with your dermatologist for evaluation. After the dermatologist examines the growth, he or she will decide whether or not to perform a biopsy. A biopsy is a simple procedure done in the office under local anesthesia. The dermatologist will first inject a small amount of anesthesia similar to the type used by your dentist. After the area is numb, the dermatologist will remove a small sample of the growth or use a small cookie-cutter device to do a "punch" biopsy. A bandage will then be placed on the wound and you will receive instructions on how to care for the wound. The area will heal over five to seven days. There are several different kinds of basal cell cancer. The biopsy results will indicate whether or not you have a basal cell cancer and what kind of basal cell cancer it is. In some cases, if the basal cell cancer is very thin and present only on the surface of the skin, your dermatologist may choose to perform the biopsy and treat the skin cancer at the same time.

The biopsy shows that I have a basal cell cancer. What is the next step?

Your dermatologist will discuss with you the various dermatologic surgical options should your growth prove to be a basal cell cancer. Your dermatologist may use a method called electrodesiccation and curettage. In this procedure the surface of the skin cancer is removed and the base of the skin cancer is gently burned or "cauterized" with an electric needle. When this is done there is often no need for further treatment. Simple surgical excision, in which the skin cancer is cut out and the skin sewn together using dermatologic cosmetic surgical techniques will often be recommended. In this case, the specimen is examined under a microscope after the procedure to determine that all the skin cancer has been removed. Other treatment methods, such as cryosurgery, radiation therapy, and laser surgery may be used in specific circumstances. In certain situations, your dermatologist may refer you for a specialized technique called Mohs micrographically controlled surgery. In this method, performed by specially trained dermatologic surgeons, the skin cancer is removed under local anesthesia in an office setting and microscopic sections are prepared on slides while you wait. Your Mohs surgeon examines the slides to determine if most of the cancer cells have been removed. If not additional layers are taken until the cancer is completely excised. The advantage of this technique is that a minimum amount of tissue is removed and all the edges of the specimen are carefully studied. This method has a high cure rate, but is not required for all skin cancers. In general, most dermatologists agree that recurrent skin cancers, that is skin cancers that were previously treated and have come back, incompletely removed skin cancers, large skin cancers, and skin cancers in cosmetically important areas, may benefit from the Mohs technique. After the skin cancer has been removed using this method, it maybe allowed to heal naturally or reconstructive surgery using a skin flap or skin graft maybe performed.

Regardless of the technique used, will I be scarred?

basal cell Because the vast majority of skin cancers occur on the face, many patients are understandably concerned about the cosmetic outcome. If the skin cancer is small, conservative methods usually produce an excellent cosmetic result. If the skin cancer requires more specialized treatment such as Mohs surgery, reconstructive options are available that, in most cases, result in an excellent cosmetic outcome.

If basal cell cancer does not travel in the blood stream to other organs like other cancers why should I bother treating it?

Some people wonder whether it is worth treating basal cell cancer at all since it doesn't metastasize or travel in the bloodstream to other organs. It is important to remember that basal cell cancer is in fact a cancer, and will continue to grow locally unless treated. Basal cell cancer does not spontaneously go away on its own. In addition, if the skin cancer is located near important organs such as the eyes, ears, and nose, or is growing near a nerve, serious problems can arise if the skin cancer is neglected.

I have already had one basal cell cancer. Am I at risk for getting another?

If you have already had one basal cell cancer studies have shown that you are at a 40% risk of getting a second basal cell cancer within five years. It is important to follow closely with your dermatologist and be alert to any non-healing sores that develop on your skin.

I have had basal cell cancer. Am I at risk of developing other skin cancers, such as melanoma?

Individuals who have had multiple basal cell cancers or other skin cancers, such as squamous cell, are at an increased risk for melanoma. It is important to have a full body skin examination at least once a year to check for abnormal moles which could be precursors to melanoma or melanoma itself. It is also important to know that basal cell cancer does not turn into melanoma.
Is there anything I can do to prevent basal cell cancer?

Because basal cell cancer is caused by ultraviolet radiation from the sun in the vast majority of cases, proper sun protection may help to prevent the development of further basal cell cancers. Because 85% of lifetime sun exposure is acquired in childhood by age 18, careful sun protection in children may effectively prevent basal cell cancer later in life. Follow these simple steps from your dermatologist and dermatologic surgeon: 1. Apply sunscreen with a sun protection factor of 15 or greater while outdoors 2. Wear a broad-brimmed hat and sun protective clothing 3. Avoid the sun between 10:00 a.m. and 4:00 p.m.

Many people wonder how often they have to reapply sunscreen. In general, if you are active outdoors, it is quite reasonable to apply sunscreen every 1 1/2 hours. As long as you practice good sun protection habits and enjoy the sun in moderate amounts you should be able to minimize the chances of developing basal cell cancer.


Cysts are benign growths that consist of a wall that makes the contents. An analogy would be a wall of a balloon that makes helium. Often these bumps are cosmetically unacceptable or patients desire removal in the event they may rupture. Although cysts can remain intact for a lifetime their rupture can lead to a great deal of inflammation and occasionally infection. This necessitates surgical excision.

Dry Skin & Keratosis Pilaris

Dry skin (eczema) and Keratosis Pilaris (bumps on the backs of the upper arms and occasionally on the thighs and buttocks) are commonly worse in the winter. Keratosis Pilaris often runs in families. If moisturizing doesn't help make an appointment because prescription strength treatment may be needed.

Eczema / Atopic Dermatitis

The terms "eczema" or "dermatitis" are used to describe certain kinds of inflamed skin conditions including allergic contact dermatitis and nummular dermatitis. Eczema can be red, blistering, oozing, scaly, brownish, or thickened and usually itches. A special type is called atopic dermatitis or atopic eczema.

Atopic Dermatitis or Atopic Eczema

The word "atopic" means there is a tendency for excess inflammation in the skin and linings of the nose and lungs. This often runs in families with allergies such as hay fever and asthma, sensitive skin, or a history of atopic dermatitis. Although most people with atopic dermatitis have family members with similar problems, 20% of them are the only ones in their family with the condition.

Atopic dermatitis is very common in all parts of the world. It affects about 10% of infants and 3% of the total population in the United States.

It can occur at any age but is most common in infants to young adults. The skin rash is very itchy and can be widespread, or limited to a few areas.

The condition frequently improves with adolescence, but many patients are affected throughout life, although not as severely as in early childhood.

Infantile Eczema

When the disease starts in infancy, it is called infantile eczema. This is an itchy, oozing, crusting rash and occurs mainly on the face and scalp, but patches can appear anywhere. Because of the itch, children may rub their head, cheeks, and other patches with a hand, a pillow, or anything within reach. Many babies improve before two years of age. Proper treatment can help until time solves the problem.

Eczema in Later Life

In teens and young adults, the patches typically occur on the hands and feet. However, any area such as the bends of the elbows, backs of the knees, ankles, wrists, face, neck, and upper chest may be affected. When it appears on the palms, backs of the hands, fingers, or on the feet, there can be episodes of crusting and oozing.

Other eczema patches in this stage are typically dry, red to brownish-gray, and may be scaly or thickened. The thickened areas may last for years without treatment. The intense, almost unbearable itching can continue, and may be most noticeable at night. Some patients scratch the skin until it bleeds and crusts. When this occurs, the skin can get infected.

Since the disease does not always follow the same pattern, proper, early, and regular treatment can bring relief and may reduce the severity and duration of the disease.
Questions and Answers About Atopic Dermatitis

Q. Since this condition is associated with allergies, can certain foods be the cause?

A. Rarely (perhaps 10%). Although some foods may provoke atopic dermatitis, especially in infants and young children with asthma, eliminating those foods is rarely a cure. You should eliminate any foods that cause immediate severe reactions or welts.

Q. Are environmental causes important and should they be eliminated?

A. Rarely. The elimination of contact or airborne substances does not bring lasting relief. Occasionally, dust and dust-catching objects like feather pillows, down comforters, kapok pillows and mattresses, cat and dog dander, carpeting, drapes, some toys, wool, and other rough fabrics, can worsen atopic dermatitis.

Q. Are skin tests, like those given for hay fever or asthma, of any value in finding the causes?

A. Sometimes, but not as a rule. A positive test means allergy only about 20% of the time. If negative, the test is good evidence against allergy.

Q. Are "shots" such as those given for hay fever and other allergies, useful?

A. Not usually. They may even make the skin condition worse in some patients.

Q. What should be done to treat this condition?

A. See your dermatologist for advice on avoiding irritating factors in creams and lotions; rough, scratchy, or tight clothing; and woolens. Rapid changes of temperature and any activity that causes sweating can aggravate atopic dermatitis. Proper bathing, moisturizing, and dealing with emotional upsets which may make the condition worse can be discussed.

Genital Warts

Genital warts, also known as venereal warts, or condylomata acuminata, are caused by the human papilloma virus (HPV). More than 100 types of HPV are known to exist. Low risk types (HPV 1, 2, and 3) cause warts on the hands, feet, and other parts of the body. Types (6 and 11) can cause warts on the genitals or anus (genital warts), and other types (HPV 16 and 18) can cause cancer of the cervix, external genitalia, and anus. The HPV types that cause genital warts only rarely cause cancer. Genital warts are usually sexually transmitted and all partners should be checked thoroughly. They can also be seen in infants who have been delivered vaginally to mothers with HPV in their genital tracts; therefore, alternate methods of delivery should be considered.

Only a small percentage of people infected with HPV will develop genital warts. Many people are "carriers" of HPV who may never develop warts, but may still be able to pass HPV to their sexual partners. The incubation period from contracting HPV until the development of warts may be several months; although, some people may not develop warts for years after contact with HPV. People who have lower immunity due to cancer, AIDS, organ transplantation, immune suppressive medications, or certain other medications are more susceptible.

Hand Eczema

Hand Eczema is dry skin of the hands. It is more common in the winter when the air holds less moisture and the cold wind increases water loss from the skin. It is worsened by frequent hand washing, using harsh soaps, not using moisturizer and not using cotton-lined rubber gloves when doing work with detergents.

Hemangiomas, Angiomas, Red Spots

Hemangiomas/Angiomas are growths of blood vessels and other red spots can be dilated blood vessels that can take the form of a birthmark (Nevus Flameus).

Hemangiomas usually occur around three weeks of life and grow out of proportion to the child for the first 8 months of life before its growth rate levels off. Therefore, it is important to evaluate these growths early especially if they are located around the eyes, mouth, genitals, scalp, neck or anus. Red bumps that we acquire with age and genetics are referred to as cherry angiomas. They are often arise later in life and while not dangerous, some patients consider them unsightly. Their treatment often requires no wound care and you can return to your daily activities.

Herpes Simplex

The herpes simplex virus (HSV) causes blisters and sores around the mouth, nose, genitals, and buttocks, but they may occur almost anywhere on the skin.

HSV infections can be very annoying because they may reappear periodically. The sores may be painful and unsightly. For chronically ill people and newborn babies, the viral infection can be serious, but rarely fatal. There are two types of HSV - Type 1 and Type 2.

Herpes Simplex Virus Type 1

Often referred to as fever blisters or cold sores, HSV Type 1 infections are tiny, clear, fluid-filled blisters that most often occur on the face. Less frequently, Type 1 infections can occur in the genital area. Type 1 may also develop in wounds on the skin.

There are two kinds of infections - primary and recurrent. Although most people get infected when exposed to the virus, only 10 percent will actually develop sores. The sores of a primary infection appear two to twenty days after contact with an infected person and can last from seven to ten days.

The number of blisters varies from one to a group of blisters. Before the blisters appear, the skin may itch, sting, burn, or tingle. The blisters can break as a result of minor injury, allowing the fluid inside the blisters to ooze and crust. Eventually, crusts fall off, leaving slightly red healing skin.

The sores from the primary infection heal completely and rarely leave a scar. However, the virus that caused the infection remains in the body. It moves to nerve cells where it remains in a resting state.

People may then have a recurrence either in the same location as the first infection or in a nearby site. The infection may recur every few weeks or not at all.

Recurrent infections tend to be mild. They can be set off by a variety of factors including fever, sun exposure, a menstrual period, trauma (including surgery), or nothing at all.


Melanoma is a cancer of the pigment producing cells in the skin, known as melanocytes. Cancer is a condition in which one type of cell grows without limit in a disorganized fashion, disrupting and replacing normal tissues and their functions, much like weeds overgrowing a garden. Normal melanocytes reside in the outer layer of the skin and produce a brown pigment called melanin, which is responsible for skin color. Melanoma occurs when melanocytes become cancerous, grow, and invade other tissues.

Melanoma begins on the surface of the skin where it is easy to see and treat. If given time to grow, melanoma can grow down into the skin, ultimately reaching the blood and lymphatic vessels, and apread around the body (metastasize), causing life-threatening illness. It is curable when detected early, but can be fatal if allowed to progress and spread. The goal is to detect melanoma early when it is still on the surface of the skin.

What causes it?

It is not certain how all cases of melanoma develop. However, it is clear that excessive sun exposure, especially severe blistering sunburns early in life, can promote melanoma development. There is evidence that ultraviolet radiation used in indoor tanning equipment may cause melanoma. The risk for developing melanoma may also be inherited.

Who gets it?

Anyone can get melanoma, but fair-skinned sun-sensitive people are at a higher risk. Since utraviolet radiation from the sun is a major culprit, people who tan poorly, or burn easily are at the greatest risk.

In addition to excessive sun exposure throughout life, people with many moles are at an increased risk to develop melanoma. The average person has around 30 moles, and most are without significance; however, people with more than 50 moles are at a greater risk. In addition to the number of moles, some people have moles that are unusual and irregular looking. These moles (nevi) are known as dysplastic or atypical moles. People with atypical moles are at increased risk of developing melanoma. Melanoma also runs in families. If a relative such as a parent, aunt or uncle had melanoma, other blood relatives are at an increased risk for melanoma. The following factors help to identify those at risk for melanoma:

  • Fair skin
  • A history of sunburns
  • More than 50 moles
  • Atypical moles
  • Close relative who have had melanoma

Anyone can develop melanoma, but people with one or more of the risk factors are more likely to do so. Periodic skin examinations by a dermatologist can truly be life saving.


Everyone has moles, sometimes 40 or more. Most people think of a mole as a dark brown spot, but moles have a wide range of appearance. At one time, a mole in a certain spot on the cheek of a woman was considered fashionable. These were called "beauty marks." Some were even painted on. However, not all moles are beautiful. They can be raised from the skin and very noticeable, they may contain dark hairs, or they may be dangerous. Moles can appear anywhere on the skin. They are usually brown in color but can be skin colored and various sizes and shapes. The brown color is caused by melanocytes, special cells that produce the pigment melanin. Moles probably are determined before a person is born. Most appear during the first 20 years of life, although some may not appear until later. Sun exposure increases the number of moles, and they may darken. During the teen years and pregnancy, moles also get darker and larger and new ones may appear. Each mole has its own growth pattern. The typical life cycle of the common mole takes about 50 years. At first, moles are flat and tan like a freckle, or they can be pink, brown or black in color, Over time, they usually enlarge and some develop hairs. As the years pass, moles can change slowly, becoming more raised and lighter in color. Some will not change at all. Some moles will slowly disappear, seeming to fade away. Others will become raised far from the skin. They may develop a small "stalk" and eventually fall off or are rubbed off. Different Types of Moles Recent studies have shown that certain types of moles have a higher-than-average risk of becoming cancerous. They may develop into a form of skin cancer known as malignant melanoma. Sunburns may increase the risk of melanoma. People with many more moles than average (greater than 100) are also more at risk for melanoma. Moles are present at birth in about 1 in 100 people. They are called congenital nevi. These moles may be more likely to develop a melanoma than moles which appear after birth. Moles known as dysplastic nevi or atypical moles are larger than average (usually larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, sometimes reddish, uneven border or black dots at edge. These moles often run in families. People with dysplastic nevi may have a greater chance of developing malignant melanoma and should be seen regularly by a dermatologist to check for any changes that might indicate skin cancer. They should also learn to do regular self-examinations, looking for changes in the color, size or shape of their moles or the appearance of new moles. Sunscreen and protective clothing should be used to shield moles from sun exposure. Recognizing the early warning signs of malignant melanoma is important. Remember the ABCDs of melanoma when examining your moles.

Molluscum Contagiosum

What is molluscum contagiosum?

Molluscum contagiosum is a common skin disease caused by a virus which affects the top layers of the skin. The name molluscum contagiosum implies that the virus develops growths that are easily spread by skin contact. Similar to warts, this virus belongs to the poxvirus family and enters the skin through small breaks of hair follicles. It does not affect any internal organs.

What do mollusum look like?

Molluscum are usually small flesh-colored or pink dome-shaped growths that often become red or inflamed. They may appear shiny and have a small indentation in the center. Because they can spread by skin-to-skin contact, molluscum are usually found in areas of skin that touch each other such as the folds in the arm or the groin. They are also found in clusters on the chest, abdomen, and buttocks and can involve the face and eyelids.

In people with immune system diseases, the molluscum may be very large in size and number, especially on the face. To confirm the diagnosis of molluscum, a dermatologist might scrape some cells from the growth and look at them under a microscope.

How do you get molluscum?

The molluscum virus is transmitted from the skin of one person who has these growths to the skin of another person. It occurs most often in cases where skin-to-skin contact is frequent, in young children — especially among siblings, or in swimming pools. If growths are present in the genital area, molluscum can be sexually transmitted.

Who is most at risk to get molluscum?

People exposed to the molluscum virus through skin-to-skin contact have an increased risk of developing these growths. Children tend to get molluscum more often than adults. It is common in young children who have not yet developed immunity to the virus. Molluscum also seems to be more common in tropical climates where warmth and humidity favor the growth of the virus.

Pityriasis Rosea

Pityriasis rosea is a rash that occurs most commonly in people between the ages of 10 and 35, but may occur at any age. The rash can last from several weeks to several months. Usually there are no permanent marks as a result of this condition, although some darker-skinned persons may develop long-lasting flat brown spots that eventually fade. It may occur at anytime of year, but pityriasis rosea is most common in the spring and fall.

Signs and Symptoms

Pityriasis rosea usually begins with a large, scaly, pink patch on the chest or back, which is called a "herold" or "mother" patch. It is frequently confused with ringworm, but antifungal creams do not help because it is not a fungus.

Within a week or two, more pink patches appear on the chest, back, arms, and legs. Patches may also occur on the neck, but rarely on the face. The patches are oval and may form a pattern over the back that resembles the outline of a Christmas tree. Sometimes the disease can produce a very severe and widespread skin eruption. About half the patients will have some itching, especially when they become warm. Physical activities like jogging and running, or bathing in hot water, may cause the rash to temporarily worsen or become more obvious. There may be other symptoms including fatigue and aching. The rash usually fades and disappears within six to eight weeks, but can sometimes last much longer.


The cause is unknown. Pityriasis rosea is not a sign of any internal disease, nor is it caused by a fungus, a bacteria, or an allergy. Thereis recent evidence suggesting that it may be caused by a virus since the rash resembles certain viral illnesses, and occasionally a personfeels slightly ill for a short while just before the rash appears. However, this has not been proven. Pityriasis rosea does not seem to spread from person to person and it usually occurs only once in a lifetime.


The diagnosis is made by a dermatologist. Pityriasis rosea affects the back, neck, chest, abdomen, upper arms, and legs, but the rash may differ from person to person making the diagnosis more difficult. The numbers and sizes of the spots can also vary, and occasionally the rash can be found in an unusual location such as the lower body, or on the face. This usually occurs in older individuals. Fungal infections, like ringworm, may resemble this rash. Reactions to certain medications, such as antibiotics, "water pill," and heart medications can also look the same as pityriasis rosea.

The dermatologist may order blood tests, scrape the skin, or take a sample from one of the spots (skin biopsy), to examine under a microscope to make the diagnosis.


Pityriasis rosea often requires no treatment and it usually goes away by itself. However, treatment may include external or internal medications for itching. Soothing medicated lotions and lubricants may be prescribed. Lukewarm rather than hot baths may be suggested. Ultraviolet light treatments given under the supervision of a dermatologist may be helpful.

Occasionally, anti-inflammatory medications such as corticosteroid may be necessary to stop itching or make the rash go away. Patients should be reassured that this disease is not a dangerous skin condition even if it occurs during pregnancy.

Remember that pityriasis rosea is a common skin disorder and is usually mild. Most cases usually do not need treatment and fortunately, even the most severe cases eventually go away.

Poison Ivy, Sumac & Oak

Those nasty weeds! Poison ivy, poison oak, and poison sumac are the most common cause of allergic reactions in the United States. Each year 10 to 50 million Americans develop an allergic rash after contact with these poison plants.

Poison ivy, poison oak, and poison sumac grow almost everywhere in the United States, except Hawaii, Alaska, and some desert areas in the Western U.S. poison ivy usually grows east of the Rocky Mountains and in Canada. Poison oak grows in the Western United States, Canada, Mexico (western poison oak), and in the Southeastern states (eastern poison oak). poison sumac grows in the Eastern states and southern Canada.

Poison Oak

In the West, this plant may grow as a vine but usually is a shrub (pictured). In the East, it grows as a shrub. It has three leaflets to form its leaves.

Poison Ivy

Grows as a vine in the East, Midwest and South, it grows as a vine. In the far Northern and Western United States, Canada and around the Great Lakes, it grows as a shrub. Each leaf has three leaflets.

Poison Sumac

Grows in standing water in peat bogs in the Northeast and Midwest and in swampy areas in parts of the Southeast. Each leaf has seven to 13 leaflets.

A Poison Plant Rash

Poison Plant rash is an allergic contact dermatitis caused by contact with oil called urushiol. Urushiol is found in the sap of poison plants like poison ivy, poison oak, and poison sumac. It is colorless or pale yellow oil that oozes from any cut or crushed part of the plant, including the roots, stems, and leaves. After exposure to air, urushiol turns brownish-black. Damaged leaves look like they have spots of black enamel paint making it easier to recognize and identify the plant. Contact with urushiol can occur in three ways:

  • Direct contact - touching the sap of the toxic plant.
  • Indirect contact - touching something on which urushiol is present. The oil can stick to the fur of animals, to garden tools or sports equipment, or to any objects that have come into contact with it.
  • Airborne contact - burning poison plants put urushiol particles into the air.

When urushiol gets on the skin, it begins to penetrate in minutes. A reaction appears usually within 12 to 48 hours. There is severe itching, redness, and swelling, followed by blisters. The rash is often arranged in streaks or lines where the person brushed against the plant. In a few days, the blisters become crusted and take 10 days or longer to heal.

Poison plant dermatitis can affect almost any part of the body. The rash does not spread by touching it, although it may seem to when it breaks out in new areas. This may happen because urushiol absorbs more slowly into skin that is thicker such as on the forearms, legs, and trunk.

Who is sensitive and who is not?

Sensitivity develops after the first direct skin contact with urushiol oil. An allergic reaction seldom occurs on the first exposure. A second encounter can produce a reaction which may be severe. About 85 percent of all people will develop an allergic reaction when adequately exposed to poison ivy. This sensitivity varies from person to person. People who reach adulthood without becoming sensitive have only a 50 percent chance of developing an allergy to poison ivy. However, only about 15 percent of people seem to be resistant.

A typical case of poison ivy

Sensitivity to poison ivy tends to decline with age. Children who have reacted to poison ivy will probably find that their sensitivity decreases by young adulthood without repeated exposure. People who were once allergic to poison ivy may even lose their sensitivity later in life.

Recognizing Poison Plants

Identifying the poison ivy plant is the first step in avoiding the rash. The popular saying "leaves of three, beware of me" is a good rule of thumb for poison ivy and poison oak but is only partly correct. A more exact saying would be "leaflets of three, beware of me," because each leaf has three leaflets. Poison sumac, however, has a row of paired leaves. The middle or end leaf is on a longer stalk than the other leaves. This differs from most other three-leaf look-alikes.

Poison ivy has different forms. It grows as vines or low shrubs. Poison oak, with its oak-like leaves, is a low shrub in the East and can be a low or high shrub in the West. Poison sumac is a tall shrub or small tree. The plants also differ in where they grow. Poison ivy grows in fertile, well-drained soil. Western poison oak needs a great deal of water, and Eastern poison oak prefers sandy soil but sometimes grows near lakes. Poison sumac tends to grow in standing water, such as peat bogs.

These plants are common in the spring and summer. When they grow, there is plenty of sap and the plants bruise easily. The leaves may have black marks where they have been injured. Although poison ivy rash is usually a summer complaint, cases may occur in winter when people are cleaning their yards and burning wood with urushiol on it, or when cutting poison ivy vines to make wreaths.

It is important to recognize these toxic plants in all seasons. In the early fall, the leaves can turn colors such as yellow or red when other plants are still green. The berry-like fruit on the mature female plants also changes color in fall, from green to off-white. In the winter, the plants lose their leaves. In the spring, poison ivy has yellow-green flowers.

Prevention of Poison Ivy

Prevent the misery of poison ivy by looking out for the plant and staying away from it. You can destroy these plants with herbicides in your own backyard, but this is not practical elsewhere. If you are going to be where you know poison ivy likely grows, wear long pants, long sleeves, boots, and gloves. Remember that the plant's nearly invisible oil, urushiol, sticks to almost all surfaces, and does not dry. Do not let pets run through wooded areas since they may carry home urushiol on their fur. Because urushiol can travel in the wind if it burns in a fire, do not burn plants that look like poison ivy.

Barrier skin creams such as a lotion containing bentoquatum offer some protection before contact with poison ivy, poison oak, or poison sumac. Over-the-counter products prevent urushiol from penetrating the skin. Ask your dermatologist for details.


If you think you've had a brush with poison ivy, poison oak, or poison sumac, follow these simple steps:

  • Wash all exposed areas with cold running water as soon as you can reach a stream, lake, or garden hose. If you can do this within five minutes, the water may keep the urushiol from contacting your skin and spreading to other parts of your body. Within the first 30 minutes, soap and water are helpful.
  • Wash your clothing in a washing machine with detergent. If you bring the clothes into your house, be careful that you do not transfer the urushiol to rugs or furniture. You may also dry clean contaminated clothes. Because urushiol can remain active for months, wash camping, sporting, fishing, or hunting gear that was in contact with the oil.
  • Relieve the itching of mild rashes by taking cool showers and applying over-the-counter preparations like calamine lotion or Burow's solution. Soaking in a lukewarm bath with an oatmeal or baking soda solution may also ease itching and dry oozing blisters. Over-the-counter hydrocortisone creams are not strong enough to have much effect on poison ivy rashes.
    Prescription cortisone can halt the reaction if used early. If you know you have been exposed and have developed severe reactions in the past, consult your dermatologist. He or she may prescribe cortisone or other medicines that can prevent blisters from forming. If you receive treatment with a cortisone drug, you should take it longer than six days, or the rash may return.

Common Myths about Poison Ivy

Scratching poison ivy blisters will spread the rash.
False. The fluid in the blisters will not spread the rash. The rash is spread only by urushiol. For instance, if you have urushiol on your hands, scratching your nose or wiping your forehead will cause a rash in those areas even though leaves did not contact the face. Avoid excessive scratching of your blisters. Your fingernails may carry bacteria that could cause an infection.

Poison ivy rash is "catchy."
. The rash is a reaction to urushiol. The rash cannot pass from person to person; only urushiol can be spread by contact.

Once allergic, always allergic to poison ivy.
A person's sensitivity changes over time, even from season to season. People who were sensitive to poison ivy as children may not be allergic as adults.

Dead poison ivy plants are no longer toxic.
Urushiol remains active for up to several years. Never handle dead plants that look like poison ivy.

Rubbing weeds on the skin can help.
Usually, prescription cortisone preparations are required to decrease the itching.

One way to protect against poison ivy is by keeping yourself covered outdoors.
However, urushiol can stick to your clothes, which your hands can touch, and then spread the oil to uncovered parts of your body. For uncovered areas, barrier creams are sometimes helpful. Learn to recognize poison ivy so you can avoid contact with it.


Pruritus is an itch or a sensation that makes a person want to scratch. Pruritus can cause discomfort and be frustrating. If it is severe, it can lead to sleeplessness, anxiety, and depression. The exact cause of an itch is unknown. It is a complex process involving nerves that respond to certain chemicals like histamine that are released in the skin, and the processing of nerve signals in the brain. Pruritus can be a part of skin diseases, internal disorders, or due to faulty processing of the itch sensation within the nervous system.

Who gets pruritus?

There are many skin diseases like urticaria (hives), varicella (chicken pox), and eczema which may have itching associated with a rash. Some skin conditions only have symptoms of pruritus without having an obvious rash. Dry skin can itch, especially in the winter, with no visual signs of a rash. Some parasitic infestations such as scabies and lice may be very itchy. Itchy, pigmented moles may be a sign of a malignant change.

Pruritus may be a manifestation of an internal condition. The most common example is kidney failure. Some types of liver disease like hepatitis, thyroid disease including both hyper (too much) and hypo (too little) thyroid hormone levels, some blood disorders such as lymphomas, iron deficiency anemia, polycythemia vera, multiple myeloma, and neurologic conditions such as pinched nerves and post herpetic neuralgia can cause itch. Infectious diseases like HIV can cause severe itching.




How is pruritus diagnosed and treated?

Often the dermatologist will be able to diagnose these conditions with an examination; however, to determine a specific cause of the itch, a blood test, skin scraping, or biopsy may be needed to help make the diagnosis. If the itch is due to a skin disease such as hives or eczema, treatment of the skin disease, itself, with prescription topical medications and/or oral antihistamines generally relieves the itch. If the itch is secondary to an internal disease, patients may require treatment of the disease, oral medication, or occasionally ultraviolet light therapy to relieve the itch.

Sometimes, the dermatologist will prescribe a cooling topical lotion or cream and/or an oral medication to relieve the itch. Pruritus is often disrupting and difficult to control but usually responds well to treatment. While a specific identifying cause for the itch may not be found, an appropriate work-up to exclude internal disease should be completed.

Although there are many causes for pruritus, some basics apply to most treatments:

  • When bathing or showering, use tepid or lukewarm water.
  • Use mild cleansers with low pH.
  • Rinse soap film off completely, pat the skin lightly, and immediately apply a moisturizing lotion or cream after bathing.
  • Wear light, loose clothing.
  • A cool work or domestic environment can help reduce the severity of itching.
  • For itchy conditions where blistering or weeping of the skin is present, such as chicken pox or poison ivy, a cool oatmeal bath or topical drying agents such as calamine lotion can be helpful.


Is a chronic relapsing skin condition where the skin cells are made to quickly often resulting in silvery scaling areas. The onset has been reported from birth to 108. However, the usual age of onset is during the 20's. There is a family history in about 66% of cases and environmental forces also seem to be at play. Trigger factors include infections (stept throat), stress and certain medications. Psoriasis can also be accompanied by Psoriatic Arthritis.


Scabies is caused by a tiny mite that has infested humans for at least 2,500 years. It is often hard to detect, and causes a fiercely, itchy skin condition. Dermatologists estimate that more than 300 million cases of scabies occur worldwide every year. The condition can strike anyone of any race or age, regardless of personal hygiene. The good news is that with better detection methods and treatments, scabies does not need to cause more than temporary distress.

How Scabies Develops

The microscopic mite that causes scabies can barely be seen by the human eye. Being a tiny, eight-legged creature with a round body, the mite burrows in the skin. Within several weeks, the patient develops an allergic reaction causing severe itching; often intense enough to keep sufferers awake all night.

Human scabies is almost always caught from another person by close contact. It could be a child, a friend, or another family member. Everyone is susceptible. Scabies is not a condition only of low-income families and neglected children, although, it is more often seen in crowded living conditions with poor hygiene.

Attracted to warmth and odor, the female mite burrows into the skin, lays eggs, and produces toxins that cause allergic reactions. Larvae, or newly hatched mites, travel to the skin surface, lying in shallow pockets where they will develop into adult mites. If the mite is scratched off the skin, it can live in bedding for up to 24 hours or more. It may take up to a month before a person will notice the itching, especially in people with good hygiene and who bathe regularly.

What to Look For

The earliest and most common symptom of scabies is itching, especially at night. Little red bumps like hives, tiny bites, or pimples appear. In more advanced cases, the skin may be crusty or scaly.

Scabies skin mite is about 0.4mm, just visible to the human eye

Scabies prefers warmer sites on the skin such as skin folds, where clothing is tight, between the fingers or under the nails, on the elbows or wrists, the buttocks or belt line, around the nipples, and on the penis. Mites also tend to hide in, or on, bracelets and watchbands, or the skin under rings. In children, the infestation may involve the entire body including the palms, soles, and scalp. The child may be tired and irritable because of loss of sleep from itching or scratching all night.

Bacterial infection may occur due to scratching. In many cases, children are treated because of infected skin lesions rather than for the scabies itself. Although treatment of bacterial infections may provide relief, recurrence is almost certain if the scabies infection itself is not treated.

Seborrheic Dermatitis

Seborrheic dermatitis is a common skin disorder that can be easily treated. This condition is a red, scaly, itchy rash most commonly seen on the scalp, sides of the nose, eyebrows, eyelids, skin behind the ears, and middle of the chest. Other areas, such as the navel (belly button), buttocks, skin folds under the arms, axillary regions, breasts, and groin, may also be involved.

Are dandruff, seborrhea and seborrheic dermatitis the same?

Dandruff appears as scaling on the scalp without redness. Seborrhea is excessive oiliness of the skin, especially of the scalp and face, without redness or scaling. Patients with seborrhea may later develop seborrheic dermatitis. Seborrheic dermatitis has both redness and scaling.

Who gets seborrheic dermatitis?

This condition is most common in three age groups - infancy when it's called "cradle cap," middle age, and the elderly. Cradle cap usually clears without treatment by age 8 to 12 months. In some infants, seborrheic dermatitis may develop only in the diaper area where it could be confused with other forms of diaper rash. When seborrheic dermatitis develops at other ages it can come and go. Seborrheic dermatitis may be seasonally aggravated particularly in northern climates; it is common in people with oily skin or hair, and may be seen with acne or psoriasis. A yeast-like organism may be involved in causing seborrheic dermatitis.

How long does this disease last?

Seborrheic dermatitis may get better on its own, but with regular treatments, the condition improves quickly.

Can it be prevented or cured?

There is no way to prevent or cure seborrheic dermatitis. However, it can be controlled with treatment.

Are laboratory tests useful in diagnosing this disease?

For most patients, there is no need to perform blood, urine, or allergy tests. In rare cases of chronic seborrheic dermatitis that do not respond to treatment, a skin biopsy or other laboratory testing may be done to eliminate the possibility of another disease.

Seborrheic Keratoses

Seborrheic Keratoses are often confused with warts or moles, but they are quite different. Seborrheic keratoses are non-cancerous growths of the outer layer of skin. There may be just one growth or many which occur in clusters. They are usually brown, but can vary in color from light tan to black and range in size from a fraction of an inch in diameter to larger than a half-dollar. A main feature of seborrheic keratoses is their waxy, "pasted-on" or "stuck-on" appearance. They sometimes look like a dab of warm brown candle wax that has dropped onto the skin or like barnacles attached to the skin.


The exact cause of seborrheic keratoses is unknown; however, they seem to run in families. They are not caused by sunlight and can be found on both sun-exposed and non sun-exposed areas. Seborrheic keratoses are more common and numerous with advancing age. Although seborrheic keratoses may first appear in one spot and seem to spread to another, they are not contagious.


Anyone may develop seborrheic keratoses. Some people develop many over time, while others develop only a few. As people age, they may simply develop more. Children rarely develop seborrheic keratoses. Seborrheic keratoses may erupt during pregnancy, following estrogen therapy, or in association with other medical problems.


Seborrheic keratoses are most often located on the chest or back, although they also can be found on the scalp, face, neck, or almost anywhere on the body. The growths usually begin one at a time as small, rough, itchy bumps which eventually thicken and develop a warty surface.

Seborrheic keratoses are benign (non-cancerous) and are NOT serious. Unless they develop suddenly, they do not indicate a serious health problem. They may be unsightly, especially if they appear on the face. Removal may be recommended if they become large, irritated, itch, or bleed easily. A seborrheic keratosis may turn black and may be difficult to distinguish from skin cancer. Such a growth must be removed and biopsied (studied under a microscope) to determine if it is cancerous or not.


Creams, ointments, or other medication can neither cure nor prevent seborrheic keratoses. Most often seborrheic keratoses are removed by cryosurgery, curettage, or electrosurgery.

Liquid nitrogen, a very cold liquid gas, is applied to the growth with a cotton swab or spray gun to "freeze" it. A blister may form under the growth which dries into a scab-like crust. The keratosis usually falls off within a few weeks. Occasionally, there will be a small dark or light spot that usually fades over time.

The keratosis is scraped from the skin. An injection or spray is first used to anesthetize (numb) the area before the growth is removed (curetted). No stitches are necessary, and the minimal bleeding can be controlled by applying pressure or the application of a blood-clotting chemical.

The growth is anesthetized (numbed) and an electric current is used to burn the growth which is then scraped off.

Skin Cancer

The three most common skin cancers include: Basal Cell Carcinoma, Squamous Cell Carcinoma and Melanomas. Besides being the most common skin cancer, Basal Cell Carcinoma is the most common cancer known to man. It is also one of the easiest to spot and treat. Squamous Cell Carcinoma is the second most common skin cancer and Melanoma the third. Despite Melanoma being the third most common form of skin cancer, it is the most deadly, accounting for 75% of all skin cancer deaths. Therefore, an annual skin check by a dermatologist and a monthly skin check by you is vital to good skin care. When these skin cancers are detected early treatment often result in cure. So please make your appointment. A half hour skin exam may be a life saver!

Skin Disorders

Squamous Cell Carcinoma

Squamous cell carcinoma is the second most common cancer of the skin. More than 250,000 new squamous cell carcinomas are diagnosed every year in the United States. Middle-aged and elderly people, especially those with fair complexions and frequent sun exposure, are most likely to be affected.

The cancer develops in the outer layer of the skin (the epithelium). Some squamous cell carcinomas arise from small sandpaper-like lesions called solar (sun) or actinic keratosis. It is possible for squamous cell carcinoma to spread to other areas of the body; therefore, early treatment is important.

What does squamous cell carcinoma look like and where does it appear?

Squamous cell carcinomas usually appear as crusted or scaly patches on the skin with a red, inflamed base, a growing tumor, or a non-healing ulcer. They are generally found in sun-exposed areas like the face, neck, arms, scalp, backs of the hands, and ears. The cancer also can occur on the lips, inside the mouth, on the genitalia, or anywhere on the body. Any lesion, especially those that do not heal, grow, bleed, or change in appearance, should be evaluated by a dermatologist.

What are the factors that cause squamous cell carcinoma?

Ultraviolet light exposure (from the sun or indoor tanning devices) greatly increases the chance of developing skin cancer. Although anyone can get squamous cell carcinoma, people with light skin who sunburn easily are at the highest risk. The chance of developing skin cancer increases with age and a history of severe sunburns as a child. Many less common skin conditions, organ transplantation, chronic skin ulcers, prior x-ray treatment (e.g., for acne in the 1950s), arsenic ingestion, smoking, and toxic exposure to tars and oils can predispose individuals to the development of squamous cell carcinoma.

How serious is squamous cell carcinoma?

These skin cancers are usually locally destructive. If left untreated, squamous cell carcinoma can destroy much of the tissue surrounding the tumor and may result in the loss of a nose or ear, for example. Aggressive types of squamous cell carcinomas, especially those on the lips and ears, or untreated cancers, can spread to the lymph nodes and other organs resulting in approximately 2,500 deaths each year in the United States.

How do dermatologists treat squamous cell carcinomas?

A skin biopsy for microscopic examination may be done to confirm the diagnosis. A variety of different treatment options can be used depending on the location of the tumor, size, microscopic characteristics, health of the patient, and other factors. Most therapies are relatively minor office-based procedures that require only local anesthesia. Surgical excision to remove the entire cancer is the most commonly used treatment. "Mohs" micrographic controlled surgery, a method which requires specialized training by dermatologic surgeons, can be used to remove the tumor while sparing as much normal skin as possible. Other dermatologic surgical procedures include laser surgery, cryosurgery (liquid nitrogen - the frozen method), radiation therapy, and electrodesiccation and curettage which involves alternately scraping and cauterizing (burning) the tumor with low levels of electricity.


Lately, the decision to obtain a tattoo has become increasingly popular, and so has the decision to remove them! An estimated 20 million Americans have tattoos, and many of them now feel that having a tattoo does not fit their new image. Those remorseful about their tattoos are consulting with cosmetic laser physicians to determine if the removal of their tattoo is possible. Today's advanced laser technology provides the means for your tattoo to be removed safely and quickly and, in most cases, without leaving a scar.

How does the treatment work?

Today, cosmetic medical lasers designed to eradicate tattoos range from a single wavelength of light to a broad spectrum of light, the varieties of which are intended to obliterate the ink in the tattoo without damaging the skin. Certain colors of light are absorbed by specific corresponding colors of the tattoo ink. The light energy vaporizes or fragments the ink particles. Your body then absorbs these ink fragments naturally and the color fades over the next couple of weeks. This treatment is very similar to methods used for years to treat birthmarks.

Telangiectasias (Dilated Blood Vessels)

Are you tired of those red lines or people commenting if you are upset; is your blood pressure to high; or if you got a sunburn? Telangectasias, or dilated red blood vessels, often occur on the face and particularly on the sides of the nose. It can be due to medical conditions such as Rosacea or collagen vascular disease or simply too much sun. Thankfully, laser is an easy in office treatment that can be performed during ones lunch break. In 10 minutes those red lines are gone and you can go right back to work. Thats right no wound care or dressings.

Tinea Versicolor

Tinea versicolor is a common skin condition due to overgrowth of a skin surface yeast. This overgrowth results in uneven skin color and scaling that can be unsightly and sometimes itch. The yeast normally lives in the pores of the skin and thrives in oily areas such as the neck, upper chest, and back.

What does tinea versicolor look like and how do you recognize it?

Tinea versicolor has small, scaly white-to-pink or tan-to-dark spots which can be scattered over the upper arms, chest and back. They may sometimes appear on the neck and the face. On light skin, tinea versicolor may be faint or can appear as tan-to-pink spots, while on dark skin tinea versicolor may be light or dark. The fungus grows slowly and prevents the skin from tanning normally. As the rest of the skin tans in the sun, the pale spots, which are affected by the yeast, become more noticeable, especially on dark skin.

What are the symptoms?

Tinea versicolor usually produces few symptoms. Occasionally, there is some slight itching that is more intense when a person gets hot.

Who may get this rash?

Most people get tinea versicolor when they are teenagers or young adults. It is rare in the elderly and children, except in tropical climates where it can occur at any age. Both dark and light skinned people are equally prone to its development. People with oily skin may be more susceptible than those with naturally dry skin.

The yeast is normally present in small numbers on everyone's skin. Anyone can develop an overgrowth of yeast. During the summer months when the temperature and humidity are high, the yeast can increase. The excess yeast on the skin prevents the normal pigmentation process, resulting in light and dark spots. In tropical countries with continuous high heat and high humidity, people can have these spots year round. In other climates, the spots generally fade in the cooler and drier months of the year. Why some people get tinea versicolor and others do not is unclear.

In tropical countries with continuous high heat and high humidity, people can have these spots year round. In other climates, the spots generally fade in the cooler and drier months of the year.

How is tinea versicolor diagnosed?

Although the light or dark colored spots can resemble other skin conditions, tinea versicolor can be easily recognized by a dermatologist. In most cases, the appearance of the skin is diagnostic, but a simple examination of the fine scales scraped from the skin can confirm the diagnosis. Scales are lightly scraped onto a slide and examined under a microscope for the presence of the yeast. A special light may help to make the diagnosis by showing a yellow green color where the skin is affected.

How is it treated?

Tinea versicolor is treated with topical or oral medications. Topical treatment includes special cleansers including some shampoos, creams, or lotions applied directly to the skin.

Several oral medications have been used successfully to treat tinea versicolor. Because of possible side effects, or interactions with other medications, the use of these prescription medicines should be supervised by your dermatologist. After any form of treatment, the uneven color of the skin may remain several months after the yeast has been eliminated until the skin repigments normally.

Tinea versicolor may recur. Special cleansers may decrease episodes when used once or twice a month, especially during warm humid months of the year.

Each patient is treated by the dermatologist according to the severity and location of the disease, the climate, and the desire of the patient. It's important to remember that the yeast is easy to kill, but it can take weeks or months for the skin to regain its normal color.

Urticaria (Hives)

Urticaria (hives) are localized, pale, itchy, pink wheals (swellings) that can burn or sting. They may occur singularly or in groups on any part of the skin; they are part of an allergic reaction and are very common. Approximately 10-20 percent of the population will have at least one episode in their lifetime. Most episodes of hives disappear quickly in a few days to a few weeks. Occasionally, a person will have them for many months or years. New hives may develop as old ones fade. Hives can vary in size form as small as a pencil eraser to as large as a dinner plate, and may join to form even larger swellings.

Hives are produced by blood plasma leaking through tiny gaps between the cells lining small blood vessels in the skin. Histamine is a chemical released from cells in the skin called "mast cells" which lie along blood vessels. Allergic reactions, chemicals in foods, or medications may cause hives; sometimes it is impossible to find out the cause. When hives form around the eyes, lips, or genitals, the tissue may swell excessively. Although frightening, the swelling usually goes away in less than 24 hours. Severe cases of hives may cause difficulty in breathing or swallowing and emergency room care is required.

Acute Urticaria

Acute urticaria lasts less than six weeks. An underlying cause can be frequently identified and eliminated. The most common causes for acute urticaria are foods, drugs, or infections. Insect bites, internal diseases, pressure, cold, or sunlight also may be responsible.


The most common foods that cause urticaria are: nuts, chocolate, shellfish, tomatoes, eggs, berries, and milk. Fresh foods cause hives more often than cooked foods. Food additives and preservatives may also cause hives.

Hives may appear within minutes to several hours after eating, depending upon the site within the digestive tract where the food is absorbed.


Almost any medication -- prescription or over-the-counter -- can cause hives. Antibiotics, pain medications, sedatives, tranquilizers, diuretics (water pills), diet supplements, antacids, arthritis medication, vitamins, herbal supplements, eye and eardrops, laxatives, vaginal douches, or any other non-prescription item can be a potential cause of urticaria. It is important to inform the dermatologist of ALL prescription and over-the-counter medications being used to help find the cause of the hives.


Many infections can cause urticaria. Viral upper-respiratory tract infections (colds) are a comon cause in children. Other viruses, including hepatitis and a number of bacterial and fungal infections, may cause urticaria.

Chronic Urticaria

Chronic urticaria lasts more than six weeks. The cause of chronic urticaria is more difficult to identify and is found only in a small percentage of patients. The dermatologist reviews a patient's medical history, asks extensive questions, and conducts a thorough physical examination. Testing, such as blood work or a biopsy, may be necessary.

Physical Urticarias

Physical urticaria may be caused by sunlight, heat, cold, water, pressure, vibration, or exercise. Solar urticaria forms within minutes of sun exposure and typically fades within one to two hours. Cold urticaria appears when the skin is warmed after exposure to cold. Urticaria, which forms in response to the cold or the water when swimming, for example, can produce wheezing, flushing, generalized hives, and fainting.

Dermatographic Urticaria (Dermatographism)

Dermatographic urticaria forms after firmly stroking or scratching the skin, and can often occur with other forms of urticaria. It affects about fuve percent of the population. Most people with this condition are otherwise healthy. Dermatographism may last for months or even years.


The best treatment for urticaria is to find and eliminate the cause whenever possible. Antihistamines are prescribed to provide relief and work best if taken on a regular schedule to prevent hives from forming. There are many antihistamines available. No one antihistamine works for everyone. The dermatologist may use combinations to control the urticaria. In severe cases, an injection of epinephrine (adrenalin) may be needed. Cortisone may also bring dramatic relief, but its use must be limited to short periods of time.

Venous Lake

A venous lake is a blue bump on the lower lip caused by a dilated vein. While it is benign it can be cosmetically unsightly. With the use of laser a venous lakes can be treated within seconds and resolve without scarring.


Vitiligo is a skin condition resulting from loss of pigment which produces white patches. Any part of the body may be affected. Usually both sides of the body are affected. Common areas of involvement are the face, lips, hands, arms, legs, and genital areas.

Who Gets Vitiligo?

Vitiligo affects one or two of every 100 people. About half the people who develop it do so before the age of 20; about one - fifth have a family member with this condition. It may be an autoimmune process (the body makes antibodies to its own pigment cells). Most people with vitiligo are in good general health, although vitiligo may occur with other autoimmune diseases such as thyroid disease

What Determines Skin Color?

Melanin, the pigment that determines color of skin, hair, and eyes, is produced in cells called melanocytes. If these cells die or cannot form melanin, the skin becomes lighter or completely white

How Does Vitiligo Develop?

Typical vitiligo shows areas of milky-white skin. However, the degree of pigment loss can vary within each vitiligo patch. There may be different shades of pigment in a patch, or a border of darker skin may circle an area of light skin.

Vitiligo often begins with a rapid loss of pigment. This may continue until, for unknown reasons, the process stops. Cycles of pigment loss, followed by times where the pigment doesn't change, may continue indefinitely.

It is rare for skin pigment in vitiligo patients to return on its own. Some people who believe they no longer have vitiligo actually have lost all their pigment and no longer have patches of contrasting skin color. Although their skin is all one color, they still have vitiligo.

The course and severity of pigment loss differ with each person. Light-skinned people usually notice the contrast between areas of vitiligo and suntanned skin in the summer. Year round, vitiligo is more obvious on people with darker skin. Individuals with severe cases can lose pigment all over the body. There is no way to predict how much pigment an individual will lose.

How is Vitiligo Treated?

Sometimes the best treatment for vitiligo is no treatment at all. In fair-skinned individuals, avoiding tanning of normal skin can make areas of vitiligo almost unnoticeable because the (no pigment) white skin, of vitiligo has no natural protection from sun. These areas are easily sunburned, and people with vitiligo have an increased risk to skin cancer. They should wear a sunscreen with a SPF of at least 30 should be used on all areas of vitiligo not covered by clothing. Avoid the sun when it is most intense to avoid burns.

Disguising vitiligo with make-up, self-tanning compounds or dyes is a safe, easy way to make it less noticeable. Waterproof cosmetics to match almost all skin colors are available. Stains that dye the skin can be used to color the white patches to more closely match normal skin color. These stains gradually wear off. Self-tanning compounds contain a chemical called dihydroxyacetone that does not need melanocytes to make the skin a tan color. The color from self-tanning creams also slowly wears off. None of these change the disease, but they can improve appearance. Micropigmentation tatooing of small areas may be helpful.

If sunscreens and cover-ups are not satisfactory, your doctor may recommend other treatment. Treatment can be aimed at returning normal pigment (repigmentation) or destroying remaining pigment (depigmentation). None of the repigmentation methods are permanent cures.

Treatment of Vitiligo in Children

Aggressive treatment is generally not used in children. Sunscreen and cover-up measures are usually the best treatments. Topical corticosteroids can also be used, but must be monitored. PUVA is usually not recommended until after age 12, and then the risks and benefits of this treatment must be carefully weighed.

Repigmentation Therapy

Topical Corticosteroids — Creams containing corticosteroid compounds can be effective in returning pigment to small areas of vitiligo. These can be used along with other treatments. These agents can thin the skin or even cause stretch marks in certain areas. They should be used under your dermatologist's care.


PUVA is a form of repigmentation therapy where a type of medication known as psoralen is used. This chemical makes the skin very sensitive to light. Then the skin is treated with a special type of ultraviolet light call UVA. Sometimes, when vitiligo is limited to a few small areas, psoralens can be applied to the vitiligo areas before UVA treatments. Usually, however, psoralens are given in pill form. Treatment with PUVA has a 50 to 70% chance of returning color on the face, trunk, and upper arms and upper legs. Hands and feet respond very poorly. Usually at least a year of twice weekly treatments are required. PUVA must be given under close supervision by your dermatologist. Side effects of PUVA include sunburn-type reactions. When used long-term, freckling of the skin may result and there is an increased risk of skin cancer. Because psoralens also make the eyes more sensitive to light, UVA blocking eyeglasses must be worn from the time of exposure to psoralen until sunset that day to prevent an increased risk of cataracts. PUVA is not usually used in children under the age of 12, in pregnant or breast feeding women, or in individuals with certain medical conditions.

Narrow Band UVB (NBUVB)

This is a form of phototherapy that requires the skin to be treated two, sometimes three, times a week for a few months. At this time this form of treatment is not widely available. It may be especially useful in treating children with vitiligo.


Transfer of skin from normal to white areas is a treatment available only in certain areas of the country and is useful for only a small group of vitiligo patients. It does not generally result in total return of pigment in treated areas.

Other Treatment Options

Other treatment options include a new topical class of drugs called immunomodulators. Due to their safety profile they may be useful in treating eyelids and children. Excimer lasers may be tried as well

Depigmentation Therapy

For some patients with extensive involvement, the most practical treatment for vitiligo is to remove remaining pigment from normal skin and make the whole body an even white color. This is done with a chemical called monobenzylether of hydroquinone. This therapy takes about a year to complete. The pigment removal is permanent.
Is Vitiligo Curable?

At this time, the exact cause of vitiligo is not known, however, there may be an inherited component. Although treatment is available, there is no single cure. Research is ongoing in vitiligo and it is hoped that new treatments will be developed.


Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. Viruses that cause warts are called human papillomavirus (HPV). Warts are usually skin-colored and feel rough to the touch, but they can be dark, flat and smooth. The appearance of a wart depends on where it is growing.

How many kinds of warts are there?

There are several different kinds of warts including:

  • Common warts
  • Foot (Plantar) warts
  • Flat warts
Common warts
usually grow on the fingers, around the nails and on the backs of the hands. They are more common where skin has been broken, for example where fingernails are bitten or hangnails picked. These are often called "seed" warts because the blood vessels to the wart produce black dots that look like seeds.

Foot warts
are usually on the soles (plantar area) of the feet and are called plantar warts. When plantar warts grow in clusters they are known as mosaic warts. Most plantar warts do not stick up above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin. Like common warts, these warts may have black dots. Plantar warts have a bad reputation because they can be painful, feeling like a stone in the shoe.
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